Provider Demographics
NPI:1225170673
Name:PAUL, LYNN (PHARMD RPH)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 ISMAY RD S
Mailing Address - Street 2:
Mailing Address - City:ISMAY
Mailing Address - State:MT
Mailing Address - Zip Code:59336-9406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3205 STOWER ST
Practice Address - Street 2:WAL-MART PHARMACY
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5785
Practice Address - Country:US
Practice Address - Phone:406-232-7320
Practice Address - Fax:406-232-3296
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5818183500000X
SD5048183500000X
NE11327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist